改良Kite技术联合Triple-button治疗急性肩锁关节脱位  

Efficacy of Arthroscopic Modified Kite Technique Combined with Triple-Button in the Treatment of Acute Acromioclavicular Joint Dislocation

作　　者：任晓伟 吴羽 李艳军[1] 罗浩[2] 马战备[1] Ren Xiaowei;Wu Yu;Li Yanjun;Luo Hao;Ma Zhanbei(DepartmentⅣof Orthopaedics,1st Central Hospital of Baoding,Baoding 071000,China;Department of Sports Medicine,the Third Hospital of Peking University,Beijing 100191,China)

机构地区：[1]保定市第一中心医院骨四科,河北保定071000 [2]北京大学第三医院运动医学科,北京100191

出　　处：《实用骨科杂志》2024年第8期696-700,共5页Journal of Practical Orthopaedics

基　　金：保定市科技计划项目(2441ZF045)。

摘　　要：目的探讨关节镜下采用改良Kite技术联合Triple-button治疗肩锁关节脱位的临床疗效。方法回顾性分析2019年12月至2022年5月保定市第一中心医院与北京大学第三医院采用关节镜下改良Kite技术结合Triple-button治疗急性肩锁关节脱位的33例患者资料。其中男21例,女12例;年龄21~58岁,平均(38.22±0.60)岁;左肩20例,右肩13例;Rockwood分型:Ⅲ型16例,Ⅴ型17例。记录患者术前、末次随访疼痛视觉模拟评分(visual analogue scale,VAS)、患侧肩关节Constant-Murley评分、肩关节前屈上举活动度(range of motion,ROM),正位X线片上测量喙突锁骨间距(coracoclavicular distance,CCD)、肩峰锁骨间距(acromioclavicular distance,ACD),记录并发症情况。结果33例患者均获得随访,随访时间6~19个月,平均(13.36±0.28)个月。患者切口均甲级愈合,无肩锁关节再脱位、锁骨和喙突骨折等并发症。VAS评分术前(7.44±0.53)分,末次随访(0.56±0.73)分,差异有统计学意义(P<0.001)。Constant-Murley评分术前(35.11±1.45)分,末次随访(90.11±2.80)分,差异有统计学意义(P<0.001)。术前肩关节前屈上举(47.22±9.39)°,末次随访(178.89±3.33)°,差异有统计学意义(P<0.001)。术前CCD为(16.73±3.73)mm,末次随访(10.61±3.24)mm,差异有统计学意义(P<0.05)。术前ACD为(12.18±3.34)mm,末次随访(6.49±2.64)mm,差异有统计学意义(P<0.001)。结论关节镜下改良Kite技术结合Triple-button治疗肩锁关节脱位安全可重复,可以获得满意的近期临床疗效,其远期疗效仍需观察。Objective To evaluate the clinical outcomes of arthroscopically assisted Improved Kite technique combined with Triple-button fixation in the surgical management of acute acromioclavicular joint dislocations.Methods A retrospective analysis was conducted on 33 patients treated with arthroscopic coracoclavicular ligament reconstruction using the Improved Kite technique combined with Triple-button fixation at Baoding No.1 Central Hospital and the Third Hospital of Peking University between December 2019 and May 2022.The study cohort included 21 males and 12 females,with ages ranging from 21 to 58 years(mean age:38.20±0.60 years).The affected side was the left shoulder in 20 patients and the right shoulder in 13 patients.Based on the Rockwood classification,16 patients were classified as TypeⅢand 17 as Type V dislocations.Preoperative and final follow-up assessments included the Visual Analogue Scale(VAS)for pain,Constant-Murley Scores(CMS)for shoulder function,and range of motion(ROM)measurements.Preoperative,postoperative,and final follow-up X-rays of the injured shoulder joint were obtained to measure the coracoclavicular distance(CCD)and acromioclavicular distance(ACD).Additionally,any complications encountered during or after the procedure were recorded.Results The 33 patients were followed up for 6 to 19 months,with a mean follow-up duration of(13.36±0.28)months.All surgical incisions healed without infection,and no complications such as recurrent dislocation,clavicle fractures,or coracoid fractures were observed.The VAS score significantly decreased from(7.44±0.53)preoperatively to(0.56±0.73)at the final follow-up(P<0.001).The CMS improved significantly from(35.11±1.45)preoperatively to(90.11±2.80)at the final follow-up(P<0.001).The forward elevation ROM of the injured shoulder improved significantly from(47.22±9.39)°preoperatively to(178.89±3.33)°at the final follow-up(P<0.001).The coracoclavicular distance(CCD)decreased significantly from(16.73±3.73)mm preoperatively to(10.61±3.24)mm at the fin

关 键 词：肩锁关节脱位 Kite技术 喙锁韧带 关节镜 Triple-button 

分 类 号：R684.7[医药卫生—骨科学]